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Clinical and microbiological features of infection with Malassezia pachydermatis in high-risk infants
P A Mickelsen1, M C Viano-Paulson, D A Stevens
1Clinical Microbiology Laboratory, Stanford University Hospital, California.
Abstract:
Malassezia pachydermatis, a yeast that has not previously been implicated as a cause of human disease, was isolated from cultures of blood from three infants. All infants were 25-27 w of gestational age and had multiple underlying medical problems. The infants had been hospitalized for at least six weeks, had received broad-spectrum antibiotics, and had received parenteral lipid nutrition via a central venous catheter. In one patient, fungemia was accompanied by clinical and laboratory evidence of Broviac catheter infection. During a three-year period, M. pachydermatis was also recovered from fungal cultures of an additional 30 patients, 85% of whom were infants. A pathogenic role for M. pachydermatis recovered from sources other than blood or catheters was not established. Risk factors for and symptoms in infants with M. pachydermatis fungemia appeared to be similar to those described for Malassezia furfur sepsis.
Insights
Malassezia pachydermatis, a yeast, caused bloodstream infections in premature infants. Risk factors and symptoms mirror those of Malassezia furfur sepsis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Neonatal Care
Background:
- Malassezia pachydermatis is a yeast not previously linked to human disease.
- Premature infants with serious health issues are vulnerable to infections.
- Central venous catheters and lipid nutrition are common in neonatal intensive care.
Observation:
- Malassezia pachydermatis was isolated from the blood of three premature infants (25-27 weeks gestational age).
- These infants had prolonged hospital stays, broad-spectrum antibiotics, and central venous catheters for lipid nutrition.
- One infant showed signs of Broviac catheter infection alongside fungemia.
Findings:
- Over three years, M. pachydermatis was found in 30 additional patients, predominantly infants (85%).
- The yeast's pathogenic role was confirmed in blood and catheter-related infections.
- Symptoms and risk factors for M. pachydermatis fungemia in infants resemble Malassezia furfur sepsis.
Implications:
- Malassezia pachydermatis should be considered a potential pathogen in neonatal intensive care units.
- Early identification and treatment are crucial for infants with M. pachydermatis fungemia.
- Further research is needed to understand the specific mechanisms and optimal management of this yeast infection in vulnerable infants.